Long-term Outcomes of Atherosclerotic Renovascular Disease in Patients Undergoing Angioplasty

Abstract

SUMMARY Background The current increase in the diagnosis of atherosclerotic renovascular disease (ARD) befalls from the progressive recognition of its clinical impact. The role of percutaneous renal angioplasty as an alternative treatment has motivated, and continuous doing it, mainfold clinical trials. Objective To analyze a population submitted to percutaneous renal angioplasty and assess the safety of the procedure and the long-term clinical response. Material and Methods There were retrospectively and consecutively included 100 patients treated percutaneously. It was carried out a follow up by telephone calls or visits (median 1.7 years, interquartile range 25-75, 1.2 to 2.7 years) during which clinical and laboratory data was collected. Results A total of 100 patients were analyzed, mostly male (72%), mean age of 67.3 ± 9.9 years, with multiple cardiovascular risk factors (HBP 95%, DLP 74%, tobaccoism 63%, DM 28%) and extensive atherosclerotic vascular involvement (coronary disease 56%, peripheral vascular disease 39%). Stent angioplasty was carried out in 98% of cases, 22% bilaterally, with a success rate of 99%. It was observed a significant decrease in systolic blood pressure (SBP) at long-term follow-up (preprocedural SBT 139.7 ± 24.2mm Hg - postprocedural SBT 129.7 ± 13.9mm Hg, P 0.001) and male sex (OR 16.2, CI 95% 4.3-105. 8: P> 0.001) were independent predictors of improvement in glomerular filtration rate at follow up. Conclusions Percutaneous treatment of renovascular disease is an additional therapeutic option of high security and good long-term outcomes in high-risk patients. Likewise it highlights the benefit of the TRA in patients with significant basal renal impairment, despite a late revascularization. REV ARGENT CARDIOL 2011;79:27-32.